Analyst PTP role at UPL managing invoice processing and vendor inquiries for financial operations. Requires SAP experience and accounting knowledge in a global organization based in Pune.
About the role
- Analyst, Case Management Field position for Aetna’s LTSS team in Illinois, requiring 50-75% travel to meet members. Focus on care coordination and healthcare outcomes for waiver members.
Responsibilities
- This Analyst, Case Management Field position is with Aetna’s Long-Term Services & Supports (LTSS) team and is a field-based position out of the Winnebago County/Rockford area in Illinois.
- The requirements is for candidates to travel 50-75% of the time to meet with members face to face.
- This position holds a full caseload to manage waiver members.
- This position requires in person quarterly visits with members.
- Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support and education for members through the use of care management tools and resources.
- Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred members' needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating members' benefit plan and available internal aid and external programs/services.
- Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
- Coordinates and implements assigned care plan activities and monitors care plan progress.
- Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
- Identifies and escalates quality of care issues through established channels.
- Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
- Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
- Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
- Helps member actively and knowledgeably participate with their provider in healthcare decision-making.
- Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Requirements
- Must reside in the state of Illinois in Winnebago County IL or Surrounding Areas
- Case management experience
- Microsoft Office and electronic health record experience
- Valid Illinois Driver’s license
- Willing and able to travel up to 75% of their time to meet with members face to face
- Reliable Transportation required, eligible for mileage reimbursement as per company policy
- Case management and discharge planning experience preferred (2 years)
- Managed Care experience preferred
- Microsoft Office experience preferred
- Bachelor’s degree or a non-licensed individual with a master’s degree, with either degree being in a human-services field (including, but not limited to sociology, special education, rehabilitation counseling)
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs
- Confidential counseling and financial coaching
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
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